de Boer Mintsje, van Middelkoop Michele, Hauptmann Michael, van der Bijl Noortje, Bosmans Jorn A W, Hendriks-Brouwer Narda, Schop Sijmen J, de Boer Jan Paul, Hijmering Nathalie J, Overbeek Lucy I H, Lobbes Marc B I, Klazen Caroline A H, de Jong Daphne, Rakhorst Hinne A, van der Hulst René R W J, van Leeuwen Flora E
Department of Plastic, Reconstructive, and Hand Surgery of Maastricht University Medical Center, Maastricht, Netherlands.
Dutch BIA-ALCL Consortium.
Aesthet Surg J. 2020 Jan 29;40(2):156-164. doi: 10.1093/asj/sjz136.
Breast implant-related health problems are a subject of fierce debate. Reliable population-based estimates of implant prevalence rates are not available, however, due to a lack of historical registries and incomplete sales data, precluding absolute risk assessments.
This study aimed to describe the methodology of a novel procedure to determine Dutch breast implant prevalence based on the evaluation of routine chest radiographs.
The validity of the new method was first examined in a separate study. Eight reviewers examined a series of 180 chest radiographs with (n = 60) or without (n = 120) a breast implant confirmed by a computed tomography or magnetic resonance imaging scan. After a consensus meeting with best-performing expert reviewers, we reviewed 3000 chest radiographs of women aged 20 to 70 years in 2 large regional hospitals in the Netherlands in 2015. To calculate the national breast implant prevalence, regional prevalence variations were corrected utilizing the National Breast Cancer Screening Program.
Eight reviewers scored with a median sensitivity of 71.7% (range, 41.7%-85.0%) and a median specificity of 94.6% (range, 73.4%-97.5%). After a consensus meeting and a reevaluation by best-performing expert reviewers, sensitivity was 79.9% and specificity was 99.2%. The estimated national prevalence of breast implants among women between 20 and 70 years was 3.0%, ranging from 1.7% at 21 to 30 years to 3.9% between 51 and 60 years.
The novel method in this study was validated with a high sensitivity and specificity, resulting in accurate prevalence estimates and providing the opportunity to conduct absolute risk assessment studies on the health consequences of breast implants.
与乳房植入物相关的健康问题是激烈辩论的主题。然而，由于缺乏历史登记数据和不完整的销售数据，无法获得基于可靠人群的植入物患病率估计值，这使得绝对风险评估无法进行。
本研究旨在描述一种基于常规胸部X光片评估来确定荷兰乳房植入物患病率的新方法。
新方法的有效性首先在一项单独研究中进行了检验。八名评审员检查了一系列180张胸部X光片，其中60张经计算机断层扫描或磁共振成像扫描证实有乳房植入物，120张没有。在与表现最佳的专家评审员召开共识会议后，我们于2015年在荷兰的两家大型地区医院对3000名年龄在20至70岁之间的女性的胸部X光片进行了复查。为计算全国乳房植入物患病率，利用国家乳腺癌筛查计划对地区患病率差异进行了校正。
八名评审员的评分中，中位敏感度为71.7%（范围为41.7%-85.0%），中位特异度为94.6%（范围为73.4%-97.5%）。在召开共识会议并由表现最佳的专家评审员重新评估后，敏感度为79.9%，特异度为99.2%。20至70岁女性中乳房植入物的估计全国患病率为3.0%，21至30岁为1.7%，51至60岁为3.9%。
本研究中的新方法经检验具有高敏感度和特异度，能得出准确的患病率估计值，并为开展关于乳房植入物健康后果的绝对风险评估研究提供了机会。
